TCT-149 Impact of Chronic Total Occlusion in a Non-Infarct-related Artery on clinical outcomes in patients undergoing Primary Percutanous Coronary Intervention: analysis of a 8 year-all-comers prospective registry

AbstractBackgroundSuccessful chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is known to be associated with improved clinical outcomes compared with failed CTO PCI. However, it is not clear whether the angiographic and clinical outcomes of long CTO lesionis different with those of short CTO lesion in the drug eluting stent (DES) era.Method sand ResultsA total of 235 consecutive patients underwent successful CTO intervention were divided into two groups according the CTO lesion length. Six-month angiographic and two-year clinical outcomes were compared between the two groups. The baseline clinical characteristics were similar between the two groups except prior PCI was more frequent in long CTO group whereas bifurcation lesion was more frequent in the short CTO group. In-hospital complications were similar between the two groups except intimal dissection was more frequent in long CTO group. Both groups had similar angiographic outcomes at 6 months and clinical outcomes up to 2 years except the incidence of repeat PCI, predominantly target vessel revascularization (TVR) was higher in long CTO group. In multivariate analysis, long CTO was an important predictor for repeat PCI (OR;4.26, CI 1.53-11.9, p=0.006).ConclusionThe safety profile, angiographic and 2-year clinical outcomes were similar between the two groups except higher incidence of repeat PCI in long CTO group despite of successful PCI with DESs.

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Chronic total occlusion in a non-infarct-related artery is closely associated with increased five-year mortality in patients with ST-segment elevation acute myocardial infarction undergoing primary percutaneous coronary intervention (from the CREDO-Kyoto AMI registry)

EuroIntervention ◽

10.4244/eij-d-15-00421 ◽

2017 ◽

Vol 12 (15) ◽

pp. e1874-e1882 ◽

Cited By ~ 11

Author(s):

Hiroki Watanabe ◽

Takeshi Morimoto ◽

Hiroki Shiomi ◽

Yutaka Furukawa ◽

Yoshihisa Nakagawa ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Chronic Total Occlusion ◽

Coronary Intervention ◽

Total Occlusion ◽

St Segment Elevation ◽

St Segment ◽

Percutaneous Coronary ◽

Infarct Related Artery ◽

Elevation Acute Myocardial Infarction

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A sex stratified long-term clinical outcome analysis in Coronary chronic total occlusion patients

10.21203/rs.3.rs-93350/v1 ◽

2020 ◽

Author(s):

Xuhe Gong ◽

Li Zhou ◽

Xiaosong Ding ◽

Hui Chen ◽

hongwei li

Keyword(s):

Clinical Outcomes ◽

Cardiac Death ◽

Chronic Total Occlusion ◽

Cox Regression ◽

Coronary Intervention ◽

Abdominal Circumference ◽

Outcome Analysis ◽

Total Occlusion ◽

Hazard Ratios ◽

History Of

Abstract Background: Differences in outcomes for women and men after percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) patients remain controversial. Herein, we compared the clinical outcomes by sex in CTO patients undergoing PCI.Methods: A total of 563 consecutive patients (19% women) who were diagnosed with CTO at a single center in China from June 2017 to December 2019 were included in this study. 300 patients were revascularized by PCI and 263 were not revascularized. The clinical outcomes of these patients stratified by sex were examined. The primary endpoints included the risk of major adverse cardiovascular and cerebrovascular events (MACCE); the secondary endpoint was cardiac death; Hazard ratios were generated using multivariable Cox regression.Results: Women represented 19% of the cohort (107/563 patients). Women have lower mean body mass index (BMI) and abdominal circumference compared with men, however, the proportion of hypertension, diabetes, and previous coronary heart disease is higher in female patients. At 2-year follow up, there were no differences between men and women for MACCE (15.8% vs 20.6%, p=0.234) and cardiac death (3.1% vs 5.6%, p=0.202). Predictors of CTO recanalization revealed that Age＜65years, absence of prior CABG, no history of DM and non-triple vessel were predictors of CTO recanalization. Sex did not predict recanalization in this regression model. Successful CTO PCI was associated with reduced MACCE.Conclusion: Our study suggests an equal benefit of CTO recanalization with a marked reduction in MACCE in women and men alike. Further dedicated studies are needed to confirm these findings.

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